1. Chest Pain Assignment Discussion
Chest Pain Assignment DiscussionBrian Foster’s Focused Assessment for Chest PainChest
pains appear in numerous forms, ranging from sharp stabs to dull aches. Sometimes, the
pain appears in the form of crushing or burning sensations. While common causes of chest
pains include weight lifting, chest trauma, and muscle strain, heart-related causes of chest
pains are more severe (Haasenritter et al., 2015). Chest pains are well-established causes of
heart attacks. According to the National Center for Health studies, 13 percent of all visits to
the emergency department result from a diagnosis of a severe heart-related problem. Major
heart-related causes of chest pains include angina, myocarditis, heart attack, and
cardiomyopathy. In light of this, the essay below analyzes subjective and objective data
obtained from a focused assessment of Brian Foster, a 58-year-old Caucasian male
presenting to the clinic with chest pains.ORDER A PLAGIARISM-FREE PAPER HEREFocus of
the AssessmentFocused assessment of Foster intends to diagnose the factors behind his
chest pain. Heart diseases are common causes of angina and heart attack. Angina is the
chest pain and discomfort occurring when the heart muscles lack sufficient oxygenated
blood. It presents in the form of pressure and squeezing in the chest, and the discomfort
affects the shoulders, neck, arms, and back. In itself, angina is not a health condition.
Instead, it signifies an underlying heart condition. Evidence-based research suggests that
heart disease is a top cause of death among men, especially individuals from racial and
ethnic minorities in the US, such as African Americans, Hispanics, and Alaska Natives
(Nowbar et al., 2019). Approximately 647000 Americans die from heart diseases every
year. The CDC estimates that 1 in every four males die from heart diseases (Center for
Disease and Control, 2020). Chest Pain Assignment DiscussionSubjective ComponentBrian
Foster reports sporadic chest pain as the chief complaint which started appearing in the
first month. He states that the pain is at the center of the chest and describes it as ‘tight and
uncomfortable.’ Foster revealed that he experienced three episodes in the last month, which
lasted several minutes, but he did not think that the episodes were related. However, he
denies pain in the arms, back, shoulder, and neck area. Brian Foster stated that activity
aggravates his chest pains and the pains occur with yard work and while walking up the
stairs. Notably, he highlighted that his pain does not worsen with eating spicy or high-fat
foods. Foster noted that his pain subsides with rest. Foster confirmed the use of medications
for hyperlipidemia and hypertension, two health conditions that significantly increase the
risk of heart diseases after an inquiry into medical history.Additionally, Foster reported a
low-stress lifestyle characterized by no regular exercise routine and high consumption of
2. grilled meat, vegetables, and sandwiches. Also, he denies moderating his salt intake. While
Foster denies illicit drug use, he confirms moderate alcohol consumption. When asked
about his general symptoms, Brian Foster denied fever, dizziness, coughing, shortness of
breath, night sweats, chills, and fatigue.Objective ComponentObjective data encompasses
information obtained by the clinician after diagnostic testing and assessment. After general
observation, Brian Foster was well-oriented and alert. He could follow all commands, had
clear speech, and could sit comfortably with no signs of distress. Cardiac tests revealed that
both S1 and S2 were audible after auscultation, with no recorded murmurs or rubs. Extra
heart sounds included gallops. Breath sounds were present in all areas, and his breathing
was unlabored. After peripheral vascular testing, Foster had no edema and JVC. His left
carotid lacked bruit while his right had bruit. The pulse of the right carotid was 3+ with
thrill.Chest Pain Assignment DiscussionHowever, Foster’s brachial and femoral pulses were
2+ without a thrill. Tibial, dorsalis, and popliteal pulses were 1+ without thrill. His abdomen
was round, soft, and without bruits. Foster’s bowel movements were had normoactive
sounds in all quadrants. There was no tenderness to deep palpation or light. Foster’s liver
was palpable 7 cm at the MCL. However, his kidneys and spleen were not palpable. After
performing the EKG, it was noted that Foster’s sinus rhythm was regular, with no ST
changes. Foster’s skin appeared pink, warm, and intact, with no tenting observed. He was
highly cooperative and could efficiently move all the four extremities. Techniques during
the physical examination of Brian Foster were auscultation, palpation, and
observation.ORDER A PLAGIARISM-FREE PAPER HEREDocumented Evidence to Support
Clinical ReasoningFrom the subjective and objective data on Brian Foster, the differential
diagnosis would include carotid disease, gastrointestinal reflux disease, congestive heart
failure, coronary heart disease with stable angina, pericarditis, and aortic aneurysm.Carotid
DiseaseIt occurs when plagues or fatty deposits block vessels delivering blood to the brain
and carotid arteries in the brain. This blockage exacerbates a person’s risk of stroke.
Stenosis is mainly caused by the build-up of cholesterol in the body. Although symptoms are
rare, brief stroke-like attack episodes are frequent. While it is an inconclusive diagnosis,
bruits observed on Foster’s carotid could be indicative of this disease.Coronary Artery
Disease with Stable AnginaAngina pectoris, also known as stable angina, is discomfort or
chest pains resulting from the disrupted flow of blood through the heart muscles (Eisen et
al., 2016). Usually, it is aggravated by strenuous activity, stress, and exercise. Common
symptoms include diaphoresis, dizziness, and fatigue.Chest Pain Assignment
DiscussionCongestive Heart FailureIn congestive heart failure, the patient progressively
presents with a buildup of fluid around the heart, ultimately affecting its pumping
mechanism. Failure of the heart to pump efficiently leads to fatigue, shortness of breath,
increased heartbeat, and swollen legs. Congestive heart failure can be ruled out in the case
of Brian Foster, as he does not have any edema.PericarditisIt is the inflammation and
irritation of the patient’s pericardium. It is characterized by sudden sharp pains that shift
from the shoulder to the neck area. This condition can be ruled out as Brian denies pain in
the neck, shoulder, arms, and back.Aortic AneurysmIt is the enlargement of the aorta to a
size of 1.5 greater than its standard size (Kuivaniemi et al., 2015). The condition is
characterized by Pulsating feeling around the navel, and Brian does not display such a
3. symptom.Gastrointestinal Reflux DiseaseThe disease occurs after stomach acid moves back
to the esophagus. Symptoms include discomfort and pain in the upper chest area. This
condition can be ruled out as chest pains associated with the disease worsen after eating,
and pain is intense regardless of the body position.Plan of CareBrian Foster’s plan of care
should start with the patient having a chest X-ray and other laboratory tests for cardiac
enzymes to obtain an accurate diagnosis for his chest pain. Also, he should be referred to a
cardiologist for an exercise stress test and carotid Doppler test, and echocardiogram.
Collaboration should be established with his cardiologist to ensure the prescription of
appropriate medications. Educating the patient on lifestyle changes, including physical
exercise and diet, is also a crucial aspect of his care plan. For follow up, the patient should
be advised to seek immediate medical attention if their chest pain worsens and is associated
with radiation, nausea, dizziness, and shortness of breath.ConclusionConclusively, early
diagnosis of heart problems is exceptionally crucial. Chest pain has been proven to be a
clinical manifestation of heart disease, and being cognizant of its cause is vital in
establishing an accurate diagnosis. In the case of Brian Foster, adequate monitoring should
be implemented to ensure that all necessary diagnostic tests are conducted, and precise
diagnosis is obtained. Foster should also be educated on the role of diet and exercise in
preventing cardiovascular diseases. Chest Pain Assignment DiscussionReferencesCenters
for Disease Control and Prevention. (2020). Heart attack. Retrieved from
https://www.cdc.gov/heartdisease/heart_attack.htmEisen, A., Bhatt, D., Steg, P., Eagle, K.,
Goto, S., & Guo, J. et al. (2016). Angina and Future Cardiovascular Events in Stable Patients
With Coronary Artery Disease: Insights From the Reduction of Atherothrombosis for
Continued Health (REACH) Registry. Journal Of The American Heart Association, 5(10).
https://doi.org/10.1161/jaha.116.004080Haasenritter, J., Biroga, T., Keunecke, C., Becker,
A., Donner-Banzhoff, N., & Dornieden, K. et al. (2015). Causes of chest pain in primary care –
a systematic review and meta-analysis. Croatian Medical Journal, 56(5), 422-430.
https://doi.org/10.3325/cmj.2015.56.422Kuivaniemi, H., Ryer, E., Elmore, J., & Tromp, G.
(2015). Understanding the pathogenesis of abdominal aortic aneurysms. Expert Review Of
Cardiovascular Therapy, 13(9), 975-987.
https://doi.org/10.1586/14779072.2015.1074861Nowbar, A., Gitto, M., Howard, J., Francis,
D., & Al-Lamee, R. (2019). Mortality From Ischemic Heart Disease. Circulation:
Cardiovascular Quality And Outcomes, 12(6).
https://doi.org/10.1161/circoutcomes.118.005375N522PE-
18B_20May__Assignment_38103715_Dellinger_Francis_N522PE__Assignment3.docxAssigne
mntThreeChestPain-1.docxChest Pain Assignment Discussion
